Opiates, Pain and Drug Laws

Published: April 3, 2007

To the Editor:

Re ''Trafficker or Healer? And Who's the Victim?'' (Findings, March 27): As a primary care physician who now practices partly in a hospice setting, I have gone from eyeing every request for opiates with suspicion to viewing pain assessment as ''the fifth vital sign'' to educating that there is no absolute upper limit to opiate dosing to relieve suffering.

Reflecting on my experiences, some of my deepest regrets are not for the patients whom I suspected might have been ''drug seeking,'' but for those who may have needlessly suffered because I was worried about ''how it might look'' to colleagues, a third-party payer or a regulatory agency to prescribe such a large dosage or quantity of pain medication.

Helen Chen, M.D.
San Francisco

To the Editor:

I have an extremely painful chronic illness and have required pain medications for about 14 years. I have never abused or misused my medications. However, whenever I visit the doctor's office, my motives are questioned, my personality scrutinized. I have had my dignity and integrity completely stripped away.

If I required insulin for diabetes or statins for heart disease, I wouldn't be treated this way. The pain has taken so much away from my physical health, but the constant unwarranted suspicion really eats away at my soul.